Pain originating in the face might be caused by an injury, an infection in a structure of the face, or a nerve disorder. Also, facial pain might begin somewhere else within the body. Facial pain sometimes occurs for no known reason.
Some common causes of facial pain:
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Abscessed tooth (a condition in which a tooth is surrounded by inflammation and pus)
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Sinus infection
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Sinusitis (inflammation of the sinuses)
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Injury to the face
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TMJ disorders (TMJ stands for temporomandibular joint, or the jaw joint.)
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Trigeminal neuralgia (described below)
What is trigeminal neuralgia (TN)?
Trigeminal neuralgia (TN) is a condition that is characterized by intermittent, shooting pain in the face. The disorder also is called tic douloureux.
Trigeminal neuralgia affects the trigeminal nerve, one of the largest nerves in the head. The trigeminal nerve sends impulses of touch, pain, pressure, and temperature to the brain from the face, jaw, gums, forehead, and around the eyes.
What causes trigeminal neuralgia?
The most frequent cause of trigeminal neuralgia is a blood vessel pressing on the nerve near the brain stem. Over time, changes in the blood vessels of the brain can result in a blood vessel’s rubbing against the trigeminal nerve root. The constant rubbing with each heartbeat wears away the insulating membrane of the nerve, resulting in nerve irritation.
What are the symptoms of trigeminal neuralgia?
Trigeminal neuralgia causes a sudden, severe, electric shock-like, or stabbing pain that lasts several seconds. The pain can be felt on the face and around the lips, eyes, nose, scalp, and forehead. Symptoms can be brought on when a person is brushing his or her teeth, putting on makeup, touching his or her face, swallowing, or even feeling a slight breeze.
Trigeminal neuralgia is often considered one of the most painful conditions seen in medicine. Usually, the pain is felt on one side of the jaw or cheek, but some patients experience pain at different times on both sides. The attacks of pain might be repeated one after the other. They might come and go throughout the day and last for days, weeks, or months at a time. At times, the attacks can disappear for months or years. The disorder is more common in women than in men and rarely affects anyone younger than 50.
How is trigeminal neuralgia diagnosed?
Magnetic resonance imaging (MRI) can be used to determine whether a tumor or multiple sclerosis is irritating the trigeminal nerve. Otherwise, no test can determine with certainty the presence of trigeminal neuralgia. Tests can help rule out other causes of facial disorders. Trigeminal neuralgia usually is diagnosed based on the patient’s description of the symptoms.
How is trigeminal neuralgia treated?
Trigeminal neuralgia can be treated with anti-seizure medicines such as Tegretol or Neurontin. The medicines Klonapin and Depakote might also be effective and might be used in combination with other drugs to achieve pain relief. Some antidepressant drugs also have significant pain relieving effects.
If medicines are ineffective or if they produce undesirable side effects, neurosurgical procedures are available to relieve pressure on the nerve or to reduce nerve sensitivity.
Some patients report having reduced or relieved pain by means of alternative medical therapies such as acupuncture, chiropractic adjustment, self-hypnosis, or meditation.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 6/23/2004
